Understanding Liver Disease Blood Tests
Blood tests are essential monitoring tools in the diagnosis and treatment of diseases that affect or are affected by the blood in your body. Patients suffering from diseases of the liver – also known as hepatic diseases – must monitor their blood on a regular basis at intervals determined by their health care provider, according to the type of disease, its severity and its progression.
At Alchemist Lab, we use blood tests as an important aspect of determining the best natural approach to treating each patient with Hepatitis or other infectious disease.
In this article, you’ll learn about the use of blood tests as an indicator of the stage of Liver Disease, as well as how to interpret the results (“numbers”) associated with several of the most common tests. In addition, we’ve provided a guide to some treatment protocols (natural supplements) that we prescribe for blood-related conditions.
Blood Tests as an Indicator of the Stage of Liver Disease
When a patient has blood tests to better understand their liver disease, quite often they – as well as their doctors – focus first on liver enzymes and viral load as a measurement of how the patient is doing. While the amount of enzymes reflects inflammation, this doesn’t answer the “big picture,” which is the stage of liver fibrosis.
This begs the question: What tests best impart clues as to the stage of liver disease?
At Alchemist Lab, we look at the following tests to get a sense of the progression of liver damage: platelets, albumin, alpha-fetoprotein, ammonia, prothrombin time and bilirubin are blood tests that reflect the stage of liver fibrosis. Of these, platelets, albumin, and bilirubin are routinely performed. Prothrombin is becoming increasingly more common in blood panels. Red and white blood cells also will often drop as liver gets fibrotic; however, many other conditions can influence red and white blood cell count, so they are not reliable markers of the stages of liver disease.
Using blood tests to ascertain the stage of disease is by no means definitive. New blood tests that will give better information are currently under development.
The first of these is called Fibrosure, which is highly inaccurate, and we at Alchemist Lab consider it worthless as a measure of liver disease stage. This test has a 29% rate of being off by at least two stages, often indicating that liver disease is worse than it actually is and frightening people, in our experience. The value of the Fibrosure test lies in it being a very good idea that will eventually be implemented effectively by tests to come.
A new version of this test called the Fibrospect is out, though we have not seen it used enough with our patients to know how accurate it is.
Combining the results of blood tests with a patient’s signs and symptoms can be very accurate in indicating the stage of liver disease. For example, if blood platelet count is below 70, albumin below 3.3, accompanied by swollen abdomen and legs (ascites), this clearly indicates that the patient has cirrhosis (stage 4).
Comprehending Blood Test Numbers
Another aspect of comprehending blood tests is knowing what the numbers mean – how low is low, how high is high. In our opinion, the best labs will alert the patient when a value on their test is truly critical.
Here are some indications of various blood tests and what the measurement ranges mean
Blood Platelets:
Every lab’s reference blood platelet range varies somewhat from other labs. The Alchemist Lab perspective on platelet count is as follows:
Normal: 140 to 400
Low: 100 to 140
Of-Concern Low: 70 to 100
Critically Low: Under 70
Danger Zone: Under 50
Alpha-fetoprotein (A-F):
Alpha-fetoprotein reference ranges can differ more dramatically between labs, ranging between 6.6 and 12 in what is considered high. What is more important is what is considered the danger zone for alpha-fetoprotein measurements.
Normal: Under 9
Elevated: 9 to 200
Beginning Stage of Danger Zone: 200 to 400
Danger Zone: Over 400
In all the years of practicing, we at Alchemist Lab have only seen one person who actually had liver cancer whose Alpha-fetoprotein value was under 200 (161). In the majority of cases of frank liver cancer we have seen, the A-F value was over 1000. Yet we routinely see patients who have been told that they are dying when their A-F levels are 25.
Albumin
Albumin, which is made in the liver, is the most abundant protein found in the blood. Albumin maintains osmotic pressure. When Albumin levels drop too low, fluid leaks out of blood vessels and causes ascites (fluid accumulation in the abdomen) and swelling of the legs.
Creating an accurate scale for albumin as an indicator of liver disease is more challenging, as we at Alchemist Lab have seen edema and ascites in patients with greater variation, including albumin levels well into the normal range.
In treating Hepatitis we at Alchemist Lab have never encountered excessive levels of albumin that can be problematic. In one scale, over 5.4 is high. We have also seen fluid accumulation cases in patients with low-normal albumin levels.
Here is a rough guide for how to use albumin levels as a measure of liver health.
Strong: 4.5 to 5.0
Good: 4.0 to 4.4
Low-Normal: 3.5 to 3.9
Low: 3.0 to 3.4
Critically Low: Under 3
Prothrombin Time (PT)
Prothrombin Time measures one of the pathways of blood coagulation – how long it takes for blod to clot. The liver synthesizes Factor VII, which is an integral part of this process. Factor VII is also Vitamin K dependent.
Tissue Factor (TF) is found outside of blood vessels. When bleeding happens, Factor VII binds with Tissue Factor, which initiates clotting.
Normally the liver has massive blood flow. As it gets damaged and fibrotic, blood does not move through the liver as easily. When this happens, the body compensates by creating additional distended blood vessels – called varices – to bring more blood to the liver.
Advanced liver disease can translate into high prothrombin, as Factor VII can be in short supply. This is critically important, as bleeding to death is a very real possibility, especially given that varices are more fragile than normal blood vessels.
For Prothrombin Time we simply call out-of-range-high an advanced warning sign of fibrotic damage.
Alchemist Lab Treatment Protocols for Blood-Related Conditions
Supplements to treat both low platelet levels and high prothrombin time levels are:
Supplements to treat low albumin levels are:
Supplements to treat high alpha-protein levels are: